Provider Demographics
NPI:1427489137
Name:DXMED
Entity type:Organization
Organization Name:DXMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIVVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-637-2608
Mailing Address - Street 1:66-590 KAM HWY STE 1B
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-1484
Mailing Address - Country:US
Mailing Address - Phone:808-637-2608
Mailing Address - Fax:
Practice Address - Street 1:66-590 KAM HWY STE 1B
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-1484
Practice Address - Country:US
Practice Address - Phone:808-637-2608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies